Endoscopic Sleeve Gastroplasty As New Hope For Mild Obesity

Aims Endoscopic Sleeve Gastroplasty (ESG) is a safe and effective treatment for obesity. To date, its indications are limited to severe obesity (BMI≥ 40 kg/m²) and morbid obesity (BMI 35-40 kg/m² with comorbidities). The aim of our study is to evaluate safety and efficacy of ESG in mild obese patients (BMI 30-35 kg/m²), regardless of comorbidities.

Methods A retrospective analysis was conducted on a database reporting consecutive mild obese patients who underwent ESG between March 2017 and October 2020. ESG safety, ΔBMI, %TBWL, %EWL, the evolution of major obesity-associated morbidities (i.e. High Blood Pressure (HBP), Hyper-INSulinemia (H-INS), Type 2 Diabetes Mellitus (T2DM) and Obstructive Sleep Apnea Syndrome (OSAS)), and the Moorehead-Ardelt Quality of Life questionnaire were analyzed at 3-, 6- and 12-months follow-up.

Results A total of 65 patients (mean age 46.3±9.4, 78.5 % female) underwent ESG. Baseline BMI was 34.3±1.4 kg/m². One patient had T2DM, 13 patients reported H-INS, 11 HBP, 3 had both H-INS and HBP and one HBP, H-INS and OSAS. No peri-procedural complications were reported. Out of the total, 44 and 34 patients respectively reached 6- and 12-months follow-up. Mean ΔBMI was 5.3±1.8, 5.3±2.2 and 4.9 ± 3.2 kg/m² at 3, 6 and 12 months. Similarly, %TBWL and %EWL were 15.3 %±5.2 and 57 % ± 19.9 at 3 months, 15.5 %±6.4 and 57.2 %±23.9 at 6 months, 14.3 %±9.3 and 53.9 % ± 35.8 at 12 months. The Moorehead-Ardelt questionnaire scored 1.5±0.7, 1.6±0.9 and 1.6±1 over follow-up. Diabetes and OSAS resolved in 100 % of the cases; H-INS and HBP resolved respectively in 43.8 % and 46.5 % within 6 months, and they similarly reported a stable improvement in 18.8 % and 6.7 % of the cases.

Endoscopic Sleeve Gastroplasty	3-months follow-up	6-months follow-up	12-months follow-up
ΔBMI (kg/m2)	5.3±1.8	5.3±2.2	4.9±3.2
%TBWL	15.3±5.2	15.5±6.4	14.3±9.3
%EWL	57±19.9	57.2±23.9	53.9±35.8
Moorehead-Ardelt QoL questionnaire	1.5±0.7	1.6±0.9	1.6±1

Conclusions ESG in mild obese patients proved to be safe and effective in terms of weight loss and comorbidities improvement. Further evidences are needed.

Citation Bove V, Carlino G, Boskoski I et al. eP146 ENDOSCOPIC SLEEVE GASTROPLASTY AS NEW HOPE FOR MILD OBESITY. Endoscopy 2021; 53: S144.

Publication History

Article published online:
19 March 2021